How does neurosurgery work? How does the surgeon identify which parts of the brain are okay to cut and which one’s arent’t? Isn’t everyone’s brain structured differently?

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With other surgeries I guess it’s possible for the surgeon to identify the different tissues, nerves, and blood vessels through an X-ray or CT scan and plan the surgery accordingly

But with the brain, doesn’t everything look like a big blob of brain tissue? How can the surgeon tell what part of the brain performs what function and what’s safe to cut so that he can access the tumor? How would he avoid a Phineas Gage type outcome?

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No, brains generally aren’t structured differently. There will be minor variations, like any other body part, but people have the same parts of the brain in the same places, and the same places do the same things. This website has useful info [https://www.hopkinsmedicine.org/health/conditions-and-diseases/anatomy-of-the-brain](https://www.hopkinsmedicine.org/health/conditions-and-diseases/anatomy-of-the-brain)

Researchers, doctors and surgeons have studied the brains of cadavers for centuries so there is understanding of the basic structure and locations of blood vessels etc, and then for each individual patient there will be Xrays, CT scans and MRIs to show their precise details.

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